2015年11月5日星期四

Complications of the Nephrotic Syndrome

First, infections

The reasons why the patients have poor resistence for the infections are as follows:

1, massive of IgG is lost with the urine;2, the lack of B factors lead to the defect of the immune and opsonic action to the bacterium; 3, when the patients are malnourished, their nonspecific immune response ability become weaker and their immune ability is more likely to be impaired; 4, large amount of transferring and zinc are last with the urine; 5, foval factors, such as pleural effusion, ascites, skin fracture and severe edema and so on, all are the induces for the infections.

Once the infections are diagnosed, patients should adopt treatment at once.

Second, hypercoagulable state and venous thrombosis

For why there is the hypercoagulable for the patients with nephrotic syndrome, this is mainly because the change of the blood coagulation factors.

Besides, the application of antibiotics, hormone and diuretic will increase the risk of venous thrombosis. When the plasma albumin is less than 2.0g/d1, the risk of the renal vein thrombosis increases. For the acute cases, the patients may have the back pain, hematuria, proteinuria, the decline of the renal function and so on. For the chronic cases, there usually is no symptom, while the protenuria symptom will aggravate. When the thrombus from fall off, it may cause the pulmonary embolism.

Some patients may are accompanied with the damage to the renal tubules.

Third, acute renal failure

Acute renal failure is one of the most serious complications of nephrotic syndrome. The main reasons for this complication are as follows:

1, the change of hemodynamics; 2, edema of the renal mesenchyme; 3, acute interstitial nephritis caused by medicines; 4, bilateral renal venous thrombosis; 5, vasoconstriction; 6, rapidly progressive glomerulonephritis; 7, urinary tract obstruction and so on.

Forth, the decline of renal tubules function

The decline of renal tubule function for nephrotic syndrome more likely occurs to children. The mechanism of this is believed that the renal tubules epithelial cells are damaged due to reabsorption of the massive protein in the urine. The common symptoms are glycosuria, acidaminuria, acidosis and so on.

Fifth, dysbolism of the bone and calcium

Due to the Vit D lost with the urine, it will lead to the dysbolism of the bone and calcium. Then many patients have the symptoms of hypocalcemia. Sometimes, the patients may have the symptoms of osteomalacia, osteitis fibrosa cystic and so on.

Sixth, coronary heart disease

Nephrotic Syndrome patients are easy to get Coronary Heart Disease due to their Hyperlipemia and high-coagulated blood. It has been improved that incidence of Myocardial Infarction to Nephrotic Syndrome patients is 8 times higher than that of normal person. Coronary Heart Disease has become the third factor causing death to Nephrotic Syndrome patients.

Seventh, disorder of electrolyte and metabolism

Applying Diuretic repeatedly or limiting salt improperly can cause Hyponatremia. Adrenal Cortical Hormone and Diuretic can cause massive urine, which can lead to Hypokalemia, if Kalium cannot be supplemented timely.


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